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    Comparison of two different techniques in emergency surgery of colon diverticulitis: Hartmann's procedure and resection with primary anastomosis
    (Wiley, 2022) Senturk, Mustafa; Celik, Abdulkadir; cakir, Murat; Yildirim, Mehmet Aykut; Belviranli, Mehmet Metin
    Colon diverticula may require emergency or elective surgery depending on its complications. Our aim is to compare the Hartmann's procedure and resection with primary anastomosis in the patients with colon diverticulitis and to demonstrate the surgical approach of our clinic. Patients were evaluated retrospectively who were operated for colon diverticulitis between January 2010 and January 2020. The patients who underwent emergency surgery for left colon diverticulitis were divided into two groups as patients with primary anastomosis resection (group 1) and Hartmann's procedure (group 2) and the groups were compared. In the aspect of the development of complications there was no remarkable difference between the groups (P = .56). Postoperative early mortality rate was similar in two groups (P = .12). According to the Hinchey classification, 31.7% of the cases were stage I, 9.8% were stage II, 31.7% were stage III, and 26.8% were stage IV. There was not a distinction in morbidity and mortality rates between Hartmann's procedure and resection with primary anastomosis. The best surgical approach should be determined by considering the operation to be performed, the patient's preferences, clinical status, and the predicted results of the surgical treatment of perforated diverticulitis.
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    Effects of Tumor Volume on Lymph Node Involvement and Prognosis at Stage pt3 Colon Cancers
    (Springer India, 2022) Senturk, Mustafa; Ozer, Halil; Celik, Abdulkadir; Yildirim, Mehmet Aykut; Cakir, Murat; Vatansev, Celalettin
    Some studies showed that the increase of tumor size has a negative effect on survival in colon cancers. Our study aims to assess the effects of tumor volume on lymph node positivity and prognosis in stage pT3 colon cancers. All patients who underwent surgery for colon cancer in our clinic were evaluated retrospectively. The study included 213 patients who were diagnosed with colon adenocarcinoma and reported as pathologic. Preoperative abdomen computed tomography scans were used for measurements of tumor volume. Tumor volumes were compared according to the pathological lymph node involvement. Cut-off values were determined with ROC analysis. The cases were divided into groups according to the determined cut-off value and data compared. Mean tumor volume was found to be higher in the lymph node-positive group (p=0.01). The higher number of removed lymph nodes and lymph node positivity was detected more in cases that were above the cut-off value (p=0.003 and p=0.004, respectively). The mean survival time was 37.3 +/- 1.3 months. There was no correlation between tumor volume and the overall survival time (p=0.21). According to data comparison of the lymph node positivity, Kaplan-Meier analysis showed that the increase of the N stage reduces the 5-year survival rate (for the N0, N1, N2 stages, 60%, 52%, 35%, respectively). Tumor volume is correlated with lymph node involvement. It has been shown that increasing the N stage has a negative effect on prognosis. Our study showed that tumor volume has no significant impact on survival but may have an indirect effect on prognosis.